Spanish adaptation and validation of the Capability Cards for use in community primary health care.

AIM: To translate, culturally adapt, and validate the Capability Cards into Spanish for use with adults living with multimorbidity in community health settings. BACKGROUND: Adults with multimorbidity face complex self-management challenges arising from multiple conditions, clinical demands, and everyday priorities. Despite this complexity, tools to support meaningful dialogue and reflection on what individuals are able to do and be in daily life are scarce. Capability Cards support structured conversations on capabilities, well-being, and life goals, fostering empowerment, reflection, and shared decision-making. Cultural adaptation to the Spanish context is essential to ensure relevance and usability in community-based care. METHODS: A methodological validation study was conducted in Lleida (Spain) following four phases: literature review to inform translation and cultural adaptation, development of instruments to assess content validity and usability, evaluation by expert and community health professional panels, and assessment with the target population. Participants included 12 experts, 19 community health professionals from nursing, physiotherapy, nutrition, and psychology, and 25 adults aged 62-81 years with multimorbidity. Content validity was evaluated using the Content Validity Index (CVI), and usability was assessed with the System Usability Scale (SUS). FINDINGS: High content validity was observed across all groups, with CVI scores above the recommended threshold (experts: 0.88; professionals: 0.96; target population: 0.98). The SUS indicated excellent usability. The Spanish version of the Capability Cards demonstrated strong content validity, cultural appropriateness, and usability, supporting its suitability as a tool for facilitating structured, person-centred conversations, with potential to promote empowerment and participatory care in community primary health care for adults with multimorbidity.